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A prospective analysis of subacute thyroid dysfunction after neck irradiation

K Nishiyama1, E Tanaka, Y Tarui

  • 1Department of Radiology, Kinki Central Hospital, Itami, Japan.

International Journal of Radiation Oncology, Biology, Physics
|January 15, 1996
PubMed
Summary

Therapeutic radiation exposure can cause thyroid dysfunction, with most patients showing elevated thyroid stimulating hormone (TSH) levels within six months. This early radiation-induced thyroid damage can lead to hypothyroidism in some individuals.

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiotherapy

Background:

  • Therapeutic radiation doses to the thyroid can cause dysfunction.
  • Early detection of radiation-induced thyroid changes is crucial.

Purpose of the Study:

  • To prospectively assess the relationship between therapeutic irradiation and early thyroid dysfunction.
  • To monitor thyroid function tests following incidental thyroid exposure during radiotherapy.

Main Methods:

  • Twenty patients with incidental thyroid irradiation (40-54 Gy) were studied.
  • Thyroid function tests (TSH, free T4, free T3, antibodies) were measured pre-irradiation and at 3, 6, and 12 months post-radiotherapy.

Main Results:

  • TSH levels did not significantly change at 3 months but were significantly elevated at 6 months in 19/20 patients.

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  • Hypothyroidism developed in 7 patients (hypothyroid group), while 13 remained euthyroid (euthyroid group).
  • TSH elevation persisted and increased exponentially in the hypothyroid group.

    • Conclusions:

    • Thyroid damage from therapeutic radiation is common, manifesting within six months.
    • Radiation-induced thyroid dysfunction requires monitoring for early hypothyroidism detection.